While mostly agreeing the current clinical document exchange standards are burdensome to providers, several electronic heath record vendors told policymakers at an Aug. 5 hearing that meaningful use stage 3, scheduled to begin in 2017, is too soon to make a change.
Use of the Consolidated-Clinical Document Architecture standard is required to meet the clinical data exchange requirements of meaningful use stage 2. However, stakeholders have claimed C-CDA is immature and complicates data exchange efforts, as the standard allows for significant variability among vendors that results in varying interpretations when developed and configured by different providers.
To help improve interoperability, a recent report by JASON, an independent group of science and technology experts that often advises the federal government, suggested using meaningful use stage 3 to move to a national, standard architecture that would facilitate data exchange. Proposals for such an architecture include application programming interfaces that would allow data to move more freely, or the recently proposed HL7 Fast Healthcare Interoperability Resources, called FHIR.
At Tuesday's hearing before the JASON task force of the Health IT Policy Committee, EHR vendors said they saw the potential in FHIR and APIs, but said it was unrealistic to make the switch by meaningful use stage 3. Ryan Hamilton, a vice president at Cerner, called the timeframe too aggressive for vendors to develop and then providers to implement the new standards.
Epic's Carl Dvorak said new data exchange standards should be developed in the marketplace after the end of the meaningful use program. "The future evolution of these standards is best left to market forces that will exist in a post-meaningful use era," he said.
More articles on meaningful use stage 3:
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IOM Recommends EHR Data Domains for MU3